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Mooren Ulcer in a Child Wearing Orthokeratology Contact Lenses
Jaeyoung Kim1, Mee Kum Kim, Won Ryang Wee
1Department of Ophthalmology (J.K., M.K.K., W.R.W., J.Y.O.), Seoul National University Hospital, Seoul, Korea; and Laboratory of Ocular Regenerative Medicine and Immunology (J.K., M.K.K., W.R.W., J.Y.O.), Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.
Insights
Mooren ulcer, a rare corneal condition, can occur in children using orthokeratology (Ortho-K) contact lenses. Early diagnosis and treatment are crucial for preserving vision in pediatric patients with this condition.
Area of Science:
- Ophthalmology
- Corneal Diseases
- Pediatric Ophthalmology
Background:
- Orthokeratology (Ortho-K) involves using rigid gas permeable contact lenses to reshape the cornea for temporary vision correction.
- While generally safe, contact lens wear, including Ortho-K, carries risks such as microbial keratitis and peripheral ulcerative keratitis.
- Mooren ulcer is a rare, progressive inflammatory condition of the peripheral cornea, typically seen in older adults, but its occurrence in pediatric populations is exceptionally uncommon.
Observation:
- A 10-year-old boy presented with a rapidly progressing peripheral corneal ulcer in his right eye.
- The patient had a four-month history of using overnight orthokeratology lenses.
- Microbiological and systemic evaluations were negative for infection or rheumatologic disease, leading to a diagnosis of Mooren ulcer.
Findings:
- The pediatric patient with orthokeratology wear was diagnosed with Mooren ulcer.
- Treatment with topical and systemic corticosteroids resulted in rapid symptom resolution and corneal healing within four weeks.
- Visual acuity returned to normal, with correction of associated astigmatism.
Implications:
- This case highlights that Mooren ulcer can manifest in pediatric patients using orthokeratology lenses.
- The potential for rapid progression in young individuals necessitates prompt diagnosis and intervention.
- Ophthalmologists should consider Mooren ulcer in the differential diagnosis of pediatric corneal ulcers, especially in contact lens wearers.
Purpose:
To report a case of Mooren ulcer that developed in a pediatric patient wearing orthokeratology overnight contact lenses.
Methods:
Case report.
Results:
A 10-year-old boy was referred to our clinic because of progressive peripheral corneal ulcer in the right eye, despite the intensive use of fortified antibiotic eye drops. The patient had been using overnight orthokeratology lenses for 4 months before presentation of corneal ulcer. There was no other history of ocular or systemic trauma and disorders. Microbiological tests of the lesion were negative. Systemic evaluation showed no sign of rheumatologic disease. Under a diagnosis of Mooren ulcer, the patient was treated with topical and systemic corticosteroids. After four weeks of treatment, the patient's symptoms rapidly disappeared, and corneal ulcer was healed. The vision recovered to normal with the correction of with-the-rule astigmatism.
Conclusions:
Mooren ulcer can develop in pediatric patients wearing orthokeratology contact lenses. Given rapid progression of Mooren ulcer in a young population, early diagnosis and proper treatment are essential to prevent a devastating outcome.
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